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Munc-Cd34

A groundbreaking clinical trial is underway to evaluate the safety and effectiveness of MUNC-CD34, a novel gene therapy approach for treating Familial Hemophagocytic Lymphohistiocytosis Type 3 (FHL 3). This innovative treatment aims to replace traditional stem cell transplants with a patient’s own genetically modified cells, potentially reducing complications and improving outcomes for those affected by this rare genetic disorder.

Table of Contents

What is MUNC-CD34?

MUNC-CD34 is an innovative gene therapy treatment being studied for patients with Familial Hemophagocytic Lymphohistiocytosis Type 3 (FHL 3). This is a rare, inherited condition that affects the immune system, causing it to become overactive and attack the body’s own tissues and organs.[1]

The therapy aims to replace a faulty gene called UNC13D, which is responsible for FHL 3. By correcting this gene, researchers hope to improve the functioning of the immune system in patients with this condition.

How Does MUNC-CD34 Work?

MUNC-CD34 works by using the patient’s own stem cells, specifically CD34+ cells. These are special cells in the bone marrow that can develop into different types of blood cells. The treatment process involves:[1]

  1. Collecting the patient’s CD34+ cells
  2. Modifying these cells in a laboratory to carry a correct version of the UNC13D gene
  3. Returning the modified cells to the patient’s body

Once back in the body, these modified cells can produce healthy immune cells that function properly, potentially alleviating the symptoms of FHL 3.

Treatment Process

The treatment with MUNC-CD34 involves several steps:[1]

  1. Preparation: The patient undergoes a process called conditioning, which helps prepare their body to receive the modified cells.
  2. MUNC-CD34 Infusion: The modified CD34+ cells are given back to the patient through an intravenous (IV) infusion. The dose is at least 2 million CD34+ cells per kilogram of body weight, with a maximum dose of 20 million cells per kilogram.
  3. MUNC-T3 Infusion: In some cases, patients may also receive a second infusion called MUNC-T3. This contains modified T-cells (another type of immune cell) and is given 14 days after the MUNC-CD34 infusion. The dose ranges from 10,000 to 5 million T-cells per kilogram of body weight.

Potential Benefits

Researchers hope that MUNC-CD34 will offer several advantages over current treatments for FHL 3:[1]

  • Avoiding complications: By using the patient’s own cells, MUNC-CD34 may help avoid severe complications associated with donor stem cell transplants, such as graft-versus-host disease (where donor cells attack the patient’s body).
  • Improved infection control: The therapy aims to provide patients with functional immune cells that can better control viral infections, which often trigger FHL 3 symptoms.
  • Better survival rates: Researchers hope this approach will improve overall survival and event-free survival for patients with FHL 3.

Safety and Monitoring

As with any new treatment, safety is a top priority. Patients receiving MUNC-CD34 will be closely monitored for:[1]

  • Side effects: Any adverse events will be carefully tracked and graded using a standardized system.
  • Recovery of blood cells: Doctors will monitor how quickly neutrophils (a type of white blood cell) and platelets return to normal levels after treatment.
  • Gene therapy effectiveness: Tests will be done to measure the presence and activity of the corrected gene in the patient’s cells.
  • Immune system function: The number and types of immune cells will be checked regularly.
  • Long-term safety: Patients will be monitored for any signs of treatment-related cancers or abnormal cell growth.

Ongoing Research

MUNC-CD34 is currently being studied in a clinical trial to evaluate its safety and effectiveness. This research will help determine:[1]

  • How well the treatment works in controlling FHL 3 symptoms
  • The short-term and long-term safety of the therapy
  • How long the benefits of the treatment last
  • The overall impact on patients’ quality of life

It’s important to note that while MUNC-CD34 shows promise, it is still an experimental treatment. More research is needed to fully understand its benefits and risks. Patients and families interested in this therapy should discuss it with their healthcare providers to determine if it might be an appropriate option for their specific situation.

Aspect Details
Treatment MUNC-CD34 gene therapy
Target Condition Familial Hemophagocytic Lymphohistiocytosis Type 3 (FHL 3)
Mechanism Autologous CD34+ cells transduced with UNC13D gene
Administration Intravenous infusion, single dose
Dosage ≥ 2 x10^6 CD34/kg, maximum 20×10^6 CD34+ cells/kg
Primary Outcomes Transplant-related mortality, adverse events, malignancy risk, RCL detection
Secondary Outcomes Cell recovery, gene expression, protein levels, immune function, integration analysis
Follow-up Duration Up to 60 months post-treatment

FAQ

  • What is MUNC-CD34 and how does it work? MUNC-CD34 is a gene therapy that uses a patient's own CD34+ cells (a type of stem cell) that have been modified to express the UNC13D gene. This gene is mutated in FHL 3 patients. The therapy aims to correct the genetic defect and restore normal immune function.
  • Who is eligible for this clinical trial? The trial is designed for patients with Familial Hemophagocytic Lymphohistiocytosis Type 3 (FHL 3) caused by mutations in the UNC13D gene. It may also be offered as a salvage treatment for those who have failed previous allogeneic stem cell transplants.
  • What are the potential benefits of MUNC-CD34 compared to traditional treatments? MUNC-CD34 may avoid severe complications associated with traditional allogeneic stem cell transplants, such as graft-versus-host disease and conditioning toxicities. It also provides immediately functional T-cells, which could help control viral infections during treatment.
  • How is the MUNC-CD34 treatment administered? MUNC-CD34 is administered intravenously on day 0 of the treatment. The dosage is at least 2 million CD34+ cells per kilogram of body weight, with a maximum dose of 20 million CD34+ cells per kilogram.
  • What follow-up care is involved after receiving MUNC-CD34? Patients will be monitored for up to 60 months after treatment. This includes regular check-ups to assess treatment effectiveness, potential side effects, and long-term outcomes. Various tests will be performed to evaluate immune function, gene expression, and overall health.

Ongoing Clinical Trials on Munc-Cd34

  • Gene Therapy Study for Familial Hemophagocytic Lymphohistiocytosis Using MUNC-CD34 and MUNC-T3 in Patients with UNC13D Gene Mutations

    Not yet recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    France

Glossary

  • Familial Hemophagocytic Lymphohistiocytosis Type 3 (FHL 3): A rare genetic disorder affecting the immune system, characterized by uncontrolled activation of immune cells leading to inflammation and organ damage.
  • CD34+ cells: A type of stem cell found in bone marrow that can develop into various blood cell types, including immune cells.
  • Gene therapy: A treatment approach that involves modifying a patient's genes to treat or prevent disease.
  • Autologous transplantation: A procedure where a patient receives their own cells or tissues, rather than those from a donor.
  • Hematopoietic Stem Cell Transplantation (HSCT): A procedure that replaces damaged or diseased bone marrow with healthy stem cells to restore normal blood cell production.
  • Graft-versus-host disease (GVHD): A complication of stem cell transplants where donor cells attack the recipient's tissues.
  • Veno-Occlusive Disease (VOD): A serious liver condition that can occur as a complication of stem cell transplantation.
  • Cytotoxic T-cells: Immune cells that can directly kill infected or abnormal cells in the body.
  • Replication-Competent Lentivirus (RCL): A potential safety concern in gene therapy where the virus used to deliver the gene could potentially replicate and cause infection.
  • Vector Copy Number (VCN): A measure of how many copies of the therapeutic gene have been inserted into the patient's cells.

References

  1. https://clinicaltrials.gov/study/NCT06736080